OBJECTIVEThe investigate the prevalence of sleep-disordered breathing (SDB) and evaluate its impact on left ventricular remodeling in adult patients with chronic heart failure (CHF).

METHODSAmbulatory sleep recording for 8 h was performed using Embletta PDS (Medcare, Iceland) in 74 patients with CHF, and the left ventricular ejection fraction (LVEF), internal end-diastolic diameter (LVIDd) and left ventricular mass weight (LVMW) were measured using M-mode and two-dimensional echocardiography.

RESULTSThe incidence of SDB defined as an apnea-hypopnea index (AHI, namely the number of apnea-hypopnea events per hour during sleep) no less than 10 was 62.16% in these CHF patients (77.78% in male and 37.93% in female patients). Of the 74 patients 31.1% had mainly obstructive sleep apnea (OSA) and 17.6% had central sleep apnea (CSA). There was a moderate inverse correlation between LVEF and AHI (P=0.004, r=-0.366). LVIDd in patients with CHF and SDB was significantly greater than that in patients with isolated CHF (46.67+/-7.29 vs 55.70+/-11.87 mm, P=0.001). The left ventricular myocardial weight was also greater in patients with CHF and SDB than in patients with isolated CHF (208.58+/-64.19 vs 291.03+/-121.54, P=0.001).

CONCLUSIONOur results suggest a higher prevalence of SDB in patients with CHF than in general population, and the prevalence is even higher in patients with severe CHF in relation to left ventricular remodeling. SDB contributes to the progression of CHF and further cardiac decline by a vicious cycle.

Adult ; Aged ; China ; epidemiology ; Echocardiography ; Female ; Heart Failure ; complications ; physiopathology ; Humans ; Male ; Middle Aged ; Polysomnography ; Prevalence ; Sleep Apnea Syndromes ; complications ; epidemiology ; Sleep Apnea, Central ; complications ; epidemiology ; Sleep Apnea, Obstructive ; complications ; epidemiology ; Ventricular Remodeling ; physiology

Obstructive sleep apnoea (OSA) and Type 2 diabetes mellitus (T2DM) are common diseases. The global prevalence of OSA is between 2% and 7% in general population cohorts. The worldwide prevalence of T2DM among adults (aged 20-79 years) was estimated to be 6.4%. The concurrent presence of OSA and T2DM can be expected in the same patient, given their high prevalence and similar predisposition. We reviewed the overlapping pathophysiology of OSA and T2DM in this article.
Adult ; Aged ; Continuous Positive Airway Pressure ; Diabetes Mellitus, Type 2 ; complications ; epidemiology ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Sleep Apnea, Obstructive ; complications ; epidemiology ; physiopathology ; therapy ; Young Adult

PURPOSE: This study aimed to evaluate the correlation between associating factors of moderate to severe asthma with obstructive sleep apnea (OSA). MATERIALS AND METHODS: One hundred and sixty-seven patients who visited the pulmonary and sleep clinic in Severance Hospital presenting with symptoms of sleep-disordered breathing were evaluated. All subjects were screened with ApneaLink. Thirty-two subjects with a high likelihood of having OSA were assessed with full polysomnography (PSG). RESULTS: The mean age was 58.8+/-12.0 years and 58.7% of subjects were male. The mean ApneaLink apnea-hypopnea index (AHI) was 12.7+/-13.0/hr. The mean ApneaLink AHI for the 32 selected high risk patients of OSA was 22.3+/-13.2/hr, which was lower than the sleep laboratory-based PSG AHI of 39.1+/-20.5/hr. When OSA was defined at an ApneaLink AHI > or =5/hr, the positive correlating factors for OSA were age, male gender, and moderate to severe asthma. CONCLUSION: Moderate to severe asthma showed strong correlation with OSA when defined at an ApneaLink AHI > or =5/hr.
Aged ; Asthma/complications/epidemiology/*etiology ; Comorbidity ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Polysomnography/instrumentation ; Severity of Illness Index ; Sleep Apnea Syndromes/epidemiology/etiology ; Sleep Apnea, Obstructive/complications/epidemiology/*physiopathology

OBJECTIVETo explore the potential role of neuropeptide Y (NPY) in the pathophysiological process of hypertension caused by obstructive sleep apnea syndrome (OSAS).

METHODSThe concentration of serum NPY were measured with radioimmunoassay (RIA) in 417 subjects (97 normotensive controls without OSAS, 113 cases of normotensive with OSAS, 73 cases of hypertensive without OSAS and 134 cases of hypertensive with OSAS. Further, the mean NPY level were compared in four groups and the possible effective factors on NPY were discussed.

RESULTS(1) The concentration of NPY in four groups were (50.5 +/- 37.2) pmol/L in normal controls, (76.0 +/- 39.9) pmol/L in normotensive with OSAS group, (66.9 +/- 36.2) pmol/L in hypertensive without OSAS group and (86.8 +/- 36.8) pmol/L in hypertensive with OSAS group. Whether the patients with OSAS combined with hypertension or not, the concentration of NPY in the serum raised remarkably compared with those without OSAS and hypertension, the highest level of serum NPY was detected in OSAS combined with hypertension group. (2) Pearson correlation analysis indicated that both SBP and DBP related to the serum NPY significantly in non-OSAS group (AHI <10), while the BMI, abdominal circumference, AHI as well as the lowest level of SaO2 correlated to NPY besides SBP in OSAS group with (AHI > or =10). (3) Multiple linear regression model showed that the abdominal circumference and AHI were contributing factors to SBP, while neck circumference and BMI were contributing factors to DBP. The level of NPY in the serum were significantly affected by AHI and BMI, in which the former one had greater influence.

CONCLUSIONThe increased level of serum NPY may play weakly potential roles in the pathophysiological process of hypertension caused by OSAS.

Adult ; Blood Pressure ; Case-Control Studies ; Female ; Humans ; Hypertension ; blood ; epidemiology ; Male ; Middle Aged ; Neuropeptide Y ; blood ; Obesity ; Sleep Apnea, Obstructive ; blood ; complications ; physiopathology